Rural-metropolitan disparities in ovarian cancer survival: A statewide population-based study
Menée aux Etats-Unis à partir de données portant sur 1 661 patientes atteintes d'un cancer de l'ovaire diagnostiqué entre 1997 et 2012, cette étude analyse les disparités géographiques dans la survie, en fonction du lieu de résidence (zone rurale ou urbaine)
Purpose : To investigate rural-metropolitan disparities in ovarian cancer survival, we assessed ovarian cancer mortality, and differences in prognostic factors by rural-metropolitan residence. Methods : The Utah Population Database was used to identify ovarian cancer cases diagnosed between 1997-2012. Residential location information at the time of cancer diagnosis was used to stratify rural-metropolitan residence. All-cause death and ovarian cancer death risks were estimated using Cox proportional hazard regression models. Results : Among 1,661 patients diagnosed with ovarian cancer, 11.8% were living in rural counties of Utah. Although ovarian cancer patients residing in rural counties had different characteristics compared to metropolitan residents, we did not observe an association between rural residence and risk of all-cause nor ovarian cancer-specific death after adjusting for confounders. However, among rural residents, ovarian cancer mortality risk was very high in older age at diagnosis and for mucinous carcinoma, and low in overweight at baseline. Conclusions : Rural residence was not significantly associated with the risk of ovarian cancer death. Nevertheless, patients residing in rural-metropolitan areas had different factors affecting the risk of all-cause mortality and cancer-specific death. Further research is needed to quantify how mortality risk can differ by residential location accounting for degree of healthcare access and lifestyle-related factors.